Age-specific associations of early life infections and preterm birth
with subsequent atopic diseases
Abstract
Background: The effects of infection and developmental adaptations in
infancy on the prevalence of subsequent atopy-related diseases at
different ages during childhood are not fully determined. This study
aims to examine the similarities and differences in the age-specific
association of asthma, allergic rhinitis/conjunctivitis, and atopic
dermatitis with early life infection (i.e., daycare, older siblings, and
severe airway infection) and developmental adaptations (i.e., preterm
birth and overweight gain) in children. Methods: In this longitudinal
cohort study (n = 47,015), children were followed from 0.5 to 11 years.
The potential risks and protective factors, including daycare attendance
at 0.5 years, existence of older siblings, history of hospitalization
due to cold/bronchitis/bronchiolitis/pneumonia during 0.5–1.5 years,
preterm birth, and overweight gain at 1.5 years, were assessed using
multivariable logistic regression with adjustments for potential
confounders. Results: A negative association was observed between early
life daycare attendance and asthma at 5.5–9 years, which disappeared
after 10 years. A negative association was also noted throughout
childhood between early life daycare attendance and the presence of
older siblings with allergic rhinitis/conjunctivitis. However, the
association between early daycare and atopic dermatitis was found to be
positive during childhood. In contrast, the early life history of
hospitalization owing to cold/bronchitis/bronchiolitis/pneumonia was
identified to be a risk factor for developing both asthma and allergic
rhinitis/conjunctivitis. Preterm birth was a significant risk factor for
childhood asthma. Conclusion: Different age-specific patterns were
demonstrated in the relationship between early life daycare, severe
airway infection, preterm birth, and atopy-related diseases in
childhood.